Angelique Kerber’s troublesome 2017 season continued in a dramatic fashion on Wednesday at the 2017 Western & Southern Open, as the former world No.1 and reigning US Open champion lost a thrilling second-round match to Ekaterina Makarova, making yet another early round exit.

After losing the first set to the Washington champion, Kerber rallied back to force a decider that climaxed in a third-set tiebreak. Played in very hot and humid conditions, the tiebreak saw Makarova struggle with cramps, at one point falling to the court in pain. The Russian pushed through the the injury woes though, rewarding herself with a major win while Kerber’s problems continue to worsen as she heads off to New York to defend her crown with only a single win since Wimbledon under her belt.

Makarova wasn’t the only player struggling with injury on Wednesday, as Petra Kvitova was dealing with a right thigh issue, losing her second-round match to Sloane Stephens. This is Kvitova’s second loss to the American on the comeback trail, having lost a close three-setter to her in Toronto last week.

While Kerber and Kvitova were struggling, world No.1 Karolina Pliskova mastered her first Cincinnati match this year in style, breezing past Russian talent Natalia Vikhlyantseva.